What they do in pelvic floor physical therapy depends on the condition they are treating.   It’s not a one size fit all therapy and therefore you will be asked about your symptoms so be prepared to explain it.  Essentially, the therapy you receive will be designed to relax or strengthen your pelvic floor muscles.

There are many reasons why an individual seek out the help of this specialize type of physical therapy this is usually performed by a female.

If you are experiencing problems with your pelvic floor organs, you can definitely benefit from pelvic floor therapy. Your pelvic floor is located between both your hip bones. The muscles in this area are arranged in a way that supports the organs below but they can also affect your mobility and stability. The strength of your core is also dependent on your pelvic muscles.

The organs in this area are as follows from front to back:

  • Urethra/bladder
  • Vagina/cervix/uterus
  • Rectum

Impairment or damage to your pelvic floor muscle can cause symptoms in any of the above. You can have problems in more than one area at the same time.

Here is the truth about pelvic floor therapy exercises that might put you at ease:

  •  It can help ease the pain in your pelvic region
  •  Treat the weakness in the pelvic muscles
  • Improve the dysfunction of the pelvic floor muscles
  • Prevent Pelvic Organ Prolapse (POP)

If you have any of the below symptoms, pelvic floor physical might help you too.

  • Painful with Intercourse
  • Leaking Stool
  • Leaking Urine
  • Pelvic Organ Prolapse
  • Chronic Constipation
  • Chronic Pelvic Pain
  • Overactive Bladder
  • Frequent Urination


However, as with anything you do for your health, you have to know what to first talk to your doctor and get recommendations or referrals. Your doctor will help you identify the root cause of the problem then come up with a treatment plan.

Not many physicians know what a pelvic floor physical therapist is or what they do. Therefore, you should ask about it and also ask for a referral.

To help you get a better understanding, here are some of the most common myths about pelvic floor therapy and the truth behind them.

It’s Painful


Pain and discomfort is very subjective but most people say it doesn’t hurt. While the assessment and treatment aspect of it requires an internal assessment and examination via your vagina or rectum, it shouldn’t be extremely painful. In fact, you should feel way better after a session.

Now, this doesn’t mean that the therapy won’t be uncomfortable. Just like other manual therapies or myofascial release there are parts where you’ll feel a bit uncomfortable. For most the discomfort is short lived.

It’s Expensive


A lot of people don’t undergo pelvic floor physical therapy in fear of its possible cost. The truth, however, is that it’s actually covered by the majority of the insurance plans today. It’s generally billed as a type of regular physical therapy so it shouldn’t be too expensive.

You will be responsible for meeting you deductible and necessary co – pays.  If you don’t have insurance they you will have to pay out of pocket. Most facilities accept cash or credit cards. You might also qualify for payment arrangement.

If you cannot afford pelvic physical therapy or you don’t have one accessible to you then a Hab It might be a good option.  This program was created by a physical therapist who also happened to be a personal trainer. In addition she experienced symptoms of pelvic floor weakness and decided to create a program for all of us.

I purchased the the program and it very easy to follow. You can do it in the comfort of your own home and on your time.

Therapy Will Not Help You Due to Your Genetic Disposition


If your mother and grandmother had issues with urinary incontinence and constipation, it’s not true that you can’t stop them from happening to you. Seeing your doctor and undergoing tests and procedures can help detect problems early on. Seeing a pelvic floor therapist is also a good way to manage pelvic floor problems the moment they start. If you think you are predispose to pelvic organ prolapse then you should keep a healthy weight, manage constipation, don’t smoke, and do your Kegel.

It’s Just for Postpartum Women


Postpartum women should definitely see a pelvic floor therapists. However, this doesn’t mean that they are the only one that can benefit from pelvic floor rehab.

You see, pelvic floor therapy can help with a wide range of pelvic floor problems. The list includes poor pelvic alignment, bladder dysfunction, incontinence, prolapse, and pain with intercourse. People who are dealing with endometriosis and pelvic pain should also see a therapist. In addition women who are planning to get pregnant can benefit from pelvic floor therapy before and during pregnancy.

It is Only For Vaginal Delivery and C-Section Delivery


It doesn’t matter how you gave birth. The fact that you got  carried your baby in your womb for 9 whole months is enough reason for you to undergo pelvic floor therapy.

This is because of the changes that happen during pregnancy.

Your growing uterus and the weight of your baby can put your pelvic floor and pelvic floor muscles under stress. If you fail to do something about it, you can end up with longer pelvic pain that those who gave birth vaginally. You can also suffer from some the same issue like stress incontinence and painful sex.

It is Not Necessary After Surgery


Most surgeries leave scars and adhesive tissues in around the area. The scars can cause pain with intercourse and other activities. If it’s too tight pelvic  floor therapy can loosen or soften the scarred tissue .

On the other hand, surgeries is the pelvic region (female reproductive and urinary surgeries) can weaken the muscles in that area. Sometimes, the surgeon has to cut through muscles and tissues in the pelvic region that can  cause weakness.

What to Expect During Pelvic Floor Therapy


Now that you know the truth behind pelvic floor therapy, it’s important to set your expectations about it, you’re scheduled for your first appointment.

During your first day, you and your therapist will talk about what’s really happening with your body. You will discuss your symptoms and how they affect your life. For instance, are you afraid of laughing because of urine leak or do you avoid sex due to coital in continence?

Your therapist will also ask about medical, sexual, surgical and medication history. Trauma to the pelvic region can affect the muscles in that area. This includes sexual trauma.

They also might ask what makes the symptoms worse or better.  Then of course you will have goals that are reasonable and can be measured.

Your therapist will also do an internal and external exam to find out any problems affecting your pelvic floor region. And to help you understand her findings, she will give you a brief explanation of the anatomy and physiology of your pelvic organs, tissues, and muscles.This is important for you to know because you can then avoid doing things to worsen the symptoms.

You will be evaluated on how you relax and control your pelvic floor muscle by way of internal examination of the pelvic floor.

During the internal examination, your therapist will ask you to undress from the waist down. You will have to lie down on your back. For your privacy and comfort, you’ll be draped.

While there are no complicated instruments involved in the assessment, your therapist will use a pair of gloves and lubrication. If you’ve experienced undergoing a pap smear, it’s quite gentler than that.

If you are comfortable with watching, you can ask your therapist to position a mirror so you can get a clear view of what’s happening. For some patients, having that sense of control makes them more comfortable and at ease throughout the procedure.

Once the exam is over, you and your therapist will start creating a plan so you can restore your pelvic floor muscles and organs to their optimum condition. She will determine how many sessions are required for your case and she’ll guide you about the exercises you can do at home to help speed up the recovery process.

A customized exercise program will be created just for you that  will teach you effective breathing, relaxation and contraction technique to optimize your results and recovery.

If your muscles are too tight then she might perform manual manipulation therapy of the pelvic floor. Think of it a massage of your pelvic floor muscle with her finger.

Another tool that might also be used is a biofeedback device. A probe is inserted inside your vagina to assess how the pelvic floor is functioning. It will also give you real-time feedback regarding if you are doing the exercise right.

Electrical stimulation can also be a part of the treatment plan. The device is programmed to give low voltage shocks to the muscles that stimulates contractions. This is indicated for individuals with weak pelvic floor muscles that are not able to contract their muscles. If you can’t do a Kegel you probably will need electric stimulation.

Another device that might be introduced to you by your therapist is a vaginal dilator. This is mainly used for women who experience pain with sex due to over tightness or spasms of the pelvic floor muscles. She will teach you how, when and how often to use it.



Now there you have it. If you think you might need it but you are still afraid first talk to your healthcare provider and also physical therapist that specializes in pelvic floor rehab.

You can’t start a program without a doctor’s order or a referral, therefore you will need to ask for one.

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